Army Pfc. Chelsea Manning is escorted on Aug. 20, 2013, to a security vehicle outside a courthouse in Fort Meade, Md., after a hearing in her court martial. (Patrick Semansky/The Associated Press)

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WASHINGTON — The Bureau of Prisons has rejected the Army's request to accept the transfer of national security leaker Pvt. Chelsea Manning from the military prison at Fort Leavenworth, Kansas, to a civilian facility where she could get better treatment for her gender-identify condition. The military will instead begin the initial treatment for her.

Defense Secretary Chuck Hagel has approved the Army's recommendation to keep Manning in military custody and start a rudimentary level of gender treatment, a defense official said Thursday. The initial gender treatments could include allowing Manning to wear some female undergarments and also possibly provide some hormone treatments.

The decision raises a number of questions about what level of treatment Manning will be able to get and at what point the private would have to be transferred from the all-male prison to a female facility.

Manning has been diagnosed with gender dysphoria, the sense of being a woman in a man's body. Civilian prisons can provide treatment, and the Defense Department has argued repeatedly that it doesn't have the medical expertise needed. As a result, the Army tried to work out a plan to transfer Manning to a federal prison.

Officials said Thursday that federal authorities refused the proposal. Officials spoke on condition of anonymity because they were not authorized to discuss the matter publicly by name.

Manning's lawyer, David Coombs, did not immediately respond to requests for comment, but in May he contended that civilian prisons were not as safe as military facilities.

In a statement, he said, "It is common knowledge that the federal prison system cannot guarantee the safety and security of Chelsea in the way that the military prison system can."

The Army sends an average of 15 to 20 prisoners a year to civilian prisons. But Manning's appeals have not been exhausted, she's still in the military and her case is of national security interest. Those are factors that normally could prevent a transfer.

According to a complaint filed by Manning, she asked that a treatment plan consider three types of measures: "real life experience," a regimen in which the person tries dressing and living in the new gender; hormone therapy, which changes some physical traits such as breast and hair growth; and sex reassignment surgery. Manning has not publicly said whether she wants surgery, and the proposed plan was not released.

Manning's treatment request was the first by a transgender military inmate, and it set up a dilemma for the department of how to treat a soldier for a diagnosed disorder without violating long-standing military policy.

The former intelligence analyst was sentenced in August for six Espionage Act violations and 14 other offenses for giving WikiLeaks more than 700,000 secret military and State Department documents, along with battlefield video, while working in Iraq in 2009 and 2010.

After the conviction, Manning announced the desire to live as a woman and legally changed her name to Chelsea Elizabeth Manning from Bradley Edward Manning.

Manning cannot be discharged from the service while serving her 35-year prison sentence.